Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Carly Diane Triebensee, PA

Individual provider Physician Assistant · NPI 1093548984

Carly Diane Triebensee, PA is a Physician Assistant in Lake Geneva, Wisconsin. Practices with Mercy Health System Corporation, a 751-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Wisconsin.

Licensed in
WI
In the registry since
2024
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

N2950 State Road 67
Lake Geneva, WI 53147-2655
Phone: (262) 245-0535
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 3400 Deerfield Dr, Janesville, WI 53546-3557 — (608) 314-3605
  • N2950 State Road 67, Lake Geneva, WI 53147-2655 — (262) 245-0535

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 8106-23 (WI)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1093548984
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 26, 2024
Last updated in NPPESSeptember 24, 2024
Certification dateSeptember 24, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Group practice Mercy Health System Corporation — 751 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Lake Geneva